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Determinants of self-rated health and the role of acculturation: implications for health inequalities

Irina L. G. Todorova · Katherine L. Tucker · Marcia Pescador Jimenez · Alisa K. Lincoln · Sandra Arévalo · Luis M. Falcón

62 citations0/0 files storedEthnicity and Health

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Health disparities and outcomes Racial and Ethnic Identity Research Gender, Health, and Social Inequality

Abstract

OBJECTIVES: Self-rated health (SRH) is an important indicator of overall health, predicting morbidity and mortality. This paper investigates what individuals incorporate into their self-assessments of health and how acculturation plays a part in this assessment. The relationship of acculturation to SRH and whether it moderates the association between indicators of health and SRH is also examined. DESIGN: The paper is based on data from adults in the Boston Puerto Rican Health Study, living in the greater Boston area (n=1357) mean age 57.2 (SD = 7.6). We used multiple regression analysis and testing for moderation effects. RESULTS: The strongest predictors of poor SRH were the number of existing medical conditions, functional problems, allostatic load and depressive symptoms. Poor SRH was also associated with being female, fewer years of education, heavy alcohol use, smoking, poverty, and low emotional support. More acculturated Puerto Rican adults rated their health more positively, which corresponded to better indicators of physical and psychological health. Additionally, acculturation moderated the association between some indicators of morbidity (functional status and depressive symptoms) and SRH.Self-assessments of overall health integrate diverse indicators, including psychological symptoms, functional status and objective health indicators such as chronic conditions and allostatic load. However, adults' assessments of overall health differed by acculturation, which moderated the association between health indicators and SRH. The data suggest that when in poor health, those less acculturated may understate the severity of their health problems when rating their overall health, thus SRH might thus conceal disparities. Using SRH can have implications for assessing health disparities in this population.

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1977The CES-D Scale 1997Self-Rated Health and Mortality: A Review of Twenty-Seven Community Studies 2010Rethinking the concept of acculturation: Implications for theory and research.1996A New Measurement of Acculturation for Hispanics: The Bidimensional Acculturation Scale for Hispanics (BAS)2006What does self rated health measure? Results from the British Whitehall II and French Gazel cohort studies 2002Socioeconomic, Cultural, and Behavioral Factors Affecting Hispanic Health Outcomes 2000Validating Self-rated Health in Different Ethnic Groups 2002Validity of Self-rated Health among Latino(a)s

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